Renal vein renin studies in a patient with renal hilar pheochromocytoma and renal artery stenosis.

Abstract

PHEOCHROMOCYTOMA and renal arterial stenosis are each important and surgically significant causes of hypertension. The combination of pheochromocytoma with renal arterial stenosis is rare, but it has been observed in a small number of patients. Table 1 lists eight such cases reported by other investigators.6' 7, 8, 16, 17, 19 Measurements of catecholamines and their metabolites are established criteria for diagnosis of pheochromocytoma.14 Recent reports from our laboratory 11 and by others 5 show that measurement of renal venous plasma renin activity is a useful diagnostic test in renovascular hypertension. If the ratio between renin activity in plasma from the side with anatomic stenosis and that from the opposite renal vein is 1.5 or greater, our experience indicates that the patient is likely to be relieved of hypertension or significantly improved by appropriate surgical correction of the lesion. It has further been shown.10,12 that assumption of an upright posture enhances renin plasma activity on the involved side far more than on the uninvolved side, and increases the ratio of the two. Studies of catecholamine and renal venous plasma renin activity were performed and were of assistance in the evaluation of a patient with the combination of left renal hilar pheochromocytoma and left renal arterial stenosis.